Morphologic features of the celiac disease include all, except –
**Core Concept**
Celiac disease is a chronic autoimmune disorder of the small intestine, characterized by an immune-mediated response to gluten in genetically predisposed individuals. The morphologic features of celiac disease are a result of this immune-mediated damage, leading to intestinal villous atrophy and crypt hyperplasia.
**Why the Correct Answer is Right**
The hallmark morphologic features of celiac disease include villous atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes. These changes are a result of the immune-mediated damage to the intestinal epithelium, leading to impaired nutrient absorption and malabsorption. The increased intraepithelial lymphocytes are a key feature, as they are responsible for the immune-mediated damage.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because it is not a morphologic feature of celiac disease. While inflammation is present, it is not a specific morphologic feature of the disease.
* **Option B:** This option is incorrect because it is a feature of celiac disease. Villous atrophy is a hallmark of the disease, resulting from immune-mediated damage to the intestinal epithelium.
* **Option C:** This option is incorrect because it is a feature of celiac disease. Crypt hyperplasia is a result of the immune-mediated damage to the intestinal epithelium, leading to an increase in the number of crypts.
* **Option D:** This option is incorrect because it is a feature of celiac disease. Increased intraepithelial lymphocytes are a key feature of the disease, responsible for the immune-mediated damage.
**Clinical Pearl / High-Yield Fact**
A classic exam trap in celiac disease is the distinction between villous atrophy and mucosal inflammation. Villous atrophy is a specific morphologic feature of celiac disease, while mucosal inflammation is a more nonspecific finding.
**Correct Answer:** A.